HEPATIC STEATOSIS IN SEVERE ACUTE MALNUTRITION AND ITS CORRELATION WITH LIPID PROFILE

Abstract

BACKGROUND- Fatty liver is a common feature of children with protein-energy malnutrition . Hepatic steatosis is usually held to be a clinical feature only of oedematous malnutrition and fatty liver does not occur in marasmus.The present study was undertaken to estimate lipid prole and its correlation with hepatic steatosis in SAM. METHODS: : This descriptive cross-sectional study was carried out over 100 children of SAM & 50 Non SAM healthy children aged 6-59 months, over a period of 1 year duration at Bal chikitsalaya Udaipur, Rajasthan, India.Awritten informed consent was taken from parents of all children who fullled the inclusion criteria. Questionnaire, General examination, Anthropometric data (Weight, Length and Mid Upper Arm Circumference) were taken. Blood samples were taken to measure plasma levels of lipid prole (Total cholesterol, triglyceride, HDL-c, LDL-c and VLDL) .Ultrasonography abdomen was done to assess the hepatic steatosis and other fatty liver changes in all study children. RESULTS-Out of total 150 cases, 100 were SAM and 50 were Non SAM. Of which 54 were males and 46 were females in SAM. Mean age of SAM children was 12.93±5.33 months, mean weight was 5.612±0.82 Kg, mean MUAC was 10.99±0.82cm,Length was 69.62±8.17 cm and BMI(kg/m2) was 11.14±1.65.The plasma levels of lipid prole (Total cholesterol, triglyceride, HDL-c , LDL-c and VLDL) were signicantly decreased in malnourished children as compared with control group. For Total cholesterol (mean ± SD: 102.06 ±29.68 versus 146.33 ±26.94 mg/dl, Triglyceride (79.71± 37.17 versus 107.32±42.07 mg/dl), HDL-c (38.02±13.82 versus 55.12±9.62 mg/dl), LDL-c (54.18±21.50 versus 80.85±19.75 mg/dl), and VLDL(21.42±8.25 versus 23.18±4.98mg/dl)in all SAM versus non SAM. All fraction of lipid were low as compared to control which was signicant p=0.001.Both oedematous and non-oedematous malnourished children had signicantly more hepatic steatosis than the control group at admission .All SAM children show hepatic steatosis with different fractions of lipid but more severe grade had show with lows cholesterol and VLDL. CONCLUSION-Plasma levels of cholesterol ,triglyceride,HDL-c and LDL-c were signicantly decreased in malnourished children.Hepatic steatosis conned to all SAM edematous and non edematous.